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Obstetric risk factors for umbilical cord prolapse: a nationwide population-based study in Japan

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objectives

To demonstrate the clinical course and the obstetric risk factors for umbilical cord prolapse.

Methods

The clinical course of reported cases of umbilical cord prolapse that occurred in Japan between 2007 and 2011 was retrospectively analyzed. The obstetric risk factors for umbilical cord prolapse were investigated by a nationwide population-based case-cohort study.

Results

Three hundred and sixty-nine cases (0.018 %) of fore-lying/prolapsed umbilical cord in 2,037,460 deliveries were analyzed. Most cases of fore-lying umbilical cord were diagnosed by an ultrasound scan (78 %), whereas umbilical cord prolapse was most frequently diagnosed by an internal examination (63 %). Umbilical cord prolapse was found to be significantly associated with the following factors: multiple pregnancy [odds ratio (OR) 3.57; 95 % confidence interval (CI) 2.60, 4.90], non-vertex presentation (OR 4.67; 95 %CI 3.73, 5.86), preterm labor (OR 2.28; 95 %CI 1.83, 2.83), premature rupture of membranes (OR 3.84; 95 %CI 3.10, 4.77), prolapsed amniotic bag (OR 12.31; 95 %CI 9.00, 16.85), polyhydramnios (OR 2.89; 95 %CI 1.49, 5.61), and a birth weight of <2500 g (OR 2.26; 95 %CI 1.84, 2.79).

Conclusion

The current study is the largest in Japan to demonstrate the obstetric clinical course and risk factors associated with umbilical cord prolapse. Prolapsed amniotic bag, labor and rupture of membrane during premature period, and fetal abnormal presentation induced by multiple pregnancy, and polyhydramnios were high risk situation for umbilical cord prolapse.

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Acknowledgments

We are grateful to everyone who answered the present questionnaire survey, and who helped conduct and analyze the present study.

Author’s contribution

Hasegawa J., Sekizawa A. and Kinoshita K. designed the research. Hasegawa J., Sekizawa A., Ikeda T., Ishiwata I. and Kinoshita K. collected the data. Hasegawa J. and Sekizawa A. analyzed and interpreted the data, and drafted the manuscript. Hasegawa J. performed the statistical analyses.

Funding

The authors declare that they received no funding in association with the present study.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kanagawa, Japan

    Junichi Hasegawa

  2. Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan

    Tomoaki Ikeda

  3. Department of Obstetrics and Gynecology, Showa University School of Medicine, Tokyo, Japan

    Akihiko Sekizawa

  4. Ishiwata Obstetrics and Gynecology Hospital, Ibaraki, Japan

    Isamu Ishiwata

  5. Seijo-Kinoshita Hospital, Tokyo, Japan

    Katsuyuki Kinoshita

Authors
  1. Junichi Hasegawa
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  2. Tomoaki Ikeda
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  3. Akihiko Sekizawa
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  4. Isamu Ishiwata
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  5. Katsuyuki Kinoshita
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Consortia

On behalf of Japan Association of Obstetricians and Gynecologists, Tokyo, Japan

Corresponding author

Correspondence to Junichi Hasegawa.

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Conflict of interest

The authors declare no conflicts of interest in association with the present study. The authors do not receive any financial support, nor do they own stock in any of the companies related to the present study.

Ethical approval

This study was approved by the ethical board in the Japan Association of Obstetricians and Gynecologists. The present study was a retrospective analysis based on a questionnaire survey. Thus, the confidentiality of the patients involved was protected and no personal data was required for the present study.

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Hasegawa, J., Ikeda, T., Sekizawa, A. et al. Obstetric risk factors for umbilical cord prolapse: a nationwide population-based study in Japan. Arch Gynecol Obstet 294, 467–472 (2016). https://doi.org/10.1007/s00404-015-3996-3

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  • DOI: https://doi.org/10.1007/s00404-015-3996-3

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